Beating a dead horse...bu seriously, when will it stop?

[exit96]

We've all read the threads here regarding "ridiculous ER C/C's," something to that effect, and the like. But as I go forward I just can't get past some of this ridiculous stuff. Actually, I can't even come up with a word that describes my disdain, displeasure, unbelief in what we have become as a society and how it has influenced "health care."

Just one example and one question: WHEN will we arrive at the point where we can responsibly and professionally tell someone who arrives to the ED, with the Chief Complaint" of- "positive home pregnancy test" that "you will not be seen for this."??????

Triage= "a sorting out"

There is no Triage level for asinine, irresponsible, frivolous, drain on the system...

I see this stuff and I seriously have trouble breathing.

I know some will warn me that "staying in ED will subject me to all kinds of foolish C/C's...agreed.

I do my part in "changing myself" and such...but WHEN will others be held accountable and change themselves. We don't have to be mathematicians to know that no "system" can survive these types of strains.

We are all crazy about "quality scores" (that are forced upon us.) and no I am not in favor of poor quality.

Do you happen to work in an ED that would turn someone like this away, and educate them? If so, how do you go about it? Or are we simply a slave to the anti-intellectual warm fuzzy environment that has permeated our entire Nation?

I'm not trying to be a jerk. And I am not focusing on calling out female complaints, this is just one example. They abound on boths sides of the gender fence.

[RN_rescue_ninja]

What can you do, except treat them and educate them on proper use of the ER? A lot of people do not realize that it's not a walk-in clinic, but then again, just as many people use it as such because they have no insurance or no way of paying a PCP/walk-in-clinic. I've heard the practitioners in our ED tell a patient that whatever complaint they came in with is really not an emergency and not appropriate to seek the ER for. I think though, that at the end of the day, these people know that. They don't believe they have any other options, and maybe many of them don't.

[exit96]

I here you...but that doesn't make it "society's problem." I've seen the huddle masses, that "don't have money for co pay," with their cell phone in hand, cigarettes in hand...fine. I don't begrudge anyone having that stuff, it's their life. But knock off the stupidity. And like you said, they likely DO know better, so why do we play along? Why do we insist on raising ANOTHER class of those who are entitled? So many of these "poor souls" don't even try to get a job...at least those in the demographic that I see on a daily basis...

[exit96]

Actually, I believe that we should be able to earmark our tax dollars for what we believe to be correct. If someone believes in this foolishness, then they can pay. My tax dollars should not go to arbitrary crap.

[RN_rescue_ninja]

Oh, it's definitely society's problem! Oh, EMTALA...how we love thee.

You can't just make ends meet without pulling from something else when there are so many peolple out there who cannot and will not pay the ER bills...even if it were billed exactly like a Dr.'s office. Because then, they'd just go to the Dr.'s office. Now, technically, the smart phone and cigarettes probably cost more than a monthly insurance plan for an individual, but then, they'd have to give up...the smart phone and cigarettes. Who would do that? Oh, well, maybe with the new "fine" on their tax return, they will comply. I'm sure of it. (it's late; that was sarcasm)

One thing I don't "get" is how someone (who is not homeless) with a minor complaint can stand the ER wait times. If it were me, and something minor, I'd say "forget this" and go home - LOL.

But aside from talking about it...what to do about it?? the whole EMTALA thing would have to be overhauled. Don't even know where to start with that.

I here you...but that doesn't make it "society's problem." I've seen the huddle masses, that "don't have money for co pay," with their cell phone in hand, cigarettes in hand...fine. I don't begrudge anyone having that stuff, it's their life. But knock off the stupidity. And like you said, they likely DO know better, so why do we play along? Why do we insist on raising ANOTHER class of those who are entitled? So many of these "poor souls" don't even try to get a job...at least those in the demographic that I see on a daily basis...

[tarotale]

exit96, I think we can be good friends. I heard once our ED physician saying he doesn't give a damn whether pt is complaining or not, he will tell them "we will not treat you for this at the ER because it doesn't meet treatment criteria. Go to your pcp or clinic" and send them home no matter what they throw at him; and voila, he gets a complaint letter... how long should we take this? well as long as the government bleeds all our hard-earned tax money dry paying for these fools that come to ED for leg pain or headache. Like others said, people think of ED as a walk-in clinic and I wish EMTALA put in a new law so we can refuse patients for bs. I had this cocaine user come in last week, doctor went in, saw her, said "send her home" to which I gladly said yes sir (stable otherwise... the addiction I guess?) The family whined at him, but nope good bye, then they decided to drive her to another ED... so yal sent her in ambulance but now all of sudden everyone has a car? I am sure they are paying their medical bills and ambulance bills... NOT. Before I came, I heard the facility made all the level 4&5s to cough up about $250 cash to be seen, then they had stopped it to my sadness. So my money pays for ton of people we call "clients" that come through our ED, AND I need to keep them happy for patient satisfaction? Now people wonder why I consider nursing as just temp job to make money...

[valzRN, ASN, RN]

When I take my dog to the emergency after hours clinic they want $150 cash before they will see my dog... no money, then the dog has to wait to go to the vet. Maybe the ED should follow suit... Just sayin'.

I have my reasons for saying that... My husband has a terminally ill disease and when I am forced to take him to the ER I see so many people that do not belong there and because of them, my husband's care is delayed. I think it's crap and something should be done. Quite honestly, as a nurse, I HATE going to the ER unless I absolutely HAVE to, and it's because of the ones that abuse the system. YES... Absolutely refuse care to those who do NOT meet emergency criteria. Maybe then the REAL patients that are there for legitimate reasons can actually get the care they need and deserve.

[Sassy5d]

Imo, let's pretend the rules were changed...

I think people would just alter their cc to fit. Much like they state cp when the waiting room is full. I think it's always going to be like this and we just need to vent offsides and otherwise grin and bear it.

[Anna Flaxis, BSN, RN]

Why would the hospital turn away customers? Even a BS complaint is a potential revenue source. We on the front lines just have to grin and bear it.

I simply will not prioritize minor complaints over the potentially or truly emergently ill. If a person has to wait six hours to be seen by a physician for the rash they've had for the last three years and it's suddenly become worthy of attention on a Friday after 5pm, then so be it. I will prioritize my time according to professional standards of patient care and safety, not convenience for some person who thinks their post nasal drip for as long as they can remember deserves the same level of concern as the guy with chest pain. But I will smile and be polite and exhibit all of the behaviors that show courtesy and concern and garner good patient satisfaction scores- as I go about my business and prioritize appropriately. ;-)

...and besides, some days, like today after the shift I had yesterday, I welcome runny noses and stubbed toes. Makes for an easy breezy day, and I could use one of those every once in a while.